Month: July 2016

The uniqueness of the time in which we live, the short decades we will grace this planet, is something to not to take for granted but to take hold of and throw ourselves into. The lives of most of those in the world is better than at any other time in history with lower rates of disease, longer lives, and greater opportunities than at any other time in history. Although we must be careful lest we be accused of chronological snobbery, we can, with confidence based on quantifiable measures, say that the majority of the world is living in circumstances better than at any other time in the past.

As many live in these historically optimal conditions, it is easy to take for granted the trappings and trimmings of modern society. During the summer I have caught myself thinking, although I would never voice this, that air conditioning is something I deserve, not a benefit I enjoy. The same can be true of clean water delivered directly to my residence, a truck to take refuse away once a week, and a handful of antibiotics or antivirals when I become ill. Conversely I have recently also caught myself wishing for more- newer electronics, larger numbers on my bank statements, and other such ‘toys’. As I thought more about what live would have been like even a century before, desires for ‘new and more’ fades, replaced by thankfulness for what I have and the opportunities I have been given. Today and everyday, let us be thankful for all that we have.

“The true soldier fights not because he hates what is in front of him, but because he loves what is behind him.”

– G.K. Chesterton

Let us not be defined by our enemies but by those we love. There will always be more enemies, more hate, more terror. Instead let us define ourselves by those we protect, by the people we stand for, by all that we love. Let us be willing to stand, willing to fight not out of fear or hate but out of love.

Life as we understand it, life as we know it, is largely a construct of human invention. Steve Jobs commented on the importance of breaking out of the scaffold of invented human life such that we can begin to drive our lives instead of our lives being dictated for us (video link below). One aspect of invented human life that we appear to be entirely constrained to, yet is an invention of humans and requires the constant faith of other humans in it to continue to work, is money.

Looking at the lives of those around us, those in the news, and within our own lives, we can readily see how important money can be. Even when money is not an obsession, it drives our lives in important ways. We exchange our time, our lives, for pieces of paper that we trust can be turned into objects of value at a later time. We save up these paper promises, invest them in portions of companies or promises of returns at a later time (stocks, bonds, etc), and base much of our lives around the hope that, decades down the road, other people will consider these representative notes to be of sufficient value to give us items of actual value at that time. To the end of gaining more of these pieces of paper we work long hours, put ourselves in dangerous positions, and in some cases, risk our freedom by attempting to obtain them through illegal means.

I have always been baffled by the athiest-agnostic argument against religion which is often stated as “faith is irrational, I only believe in concrete truths and science.” Allow me to make two primary objections to that argument, although the focus is on the first:

While I appreciate the sentiment of this, an honest observer must admit that so much of life as a human being relies upon some manner of faith, whether that be faith in our monetary system or faith in other figments of human imagination and construction.

While one may aspire to only believe in concrete truths and science, we as a scientific community and as humans with a limited capacity for processing and remembrance, cannot possibly claim to achieve this.

In our limited human capacities we strive for objectivity, but are dominated by subjectivity. Consider that the monetary system we have today, especially the stock markets, are not well understood not just by the lay person, but also by the expert. Original monetary systems worked in a similar way toChuck-E-Cheese’s where you could use an object of no value (tickets) to trade for something of value (let’s be honest, nothing at Chuck-E-Cheese’s has value). Now, with much of the world’s wealth in stocks, bonds, and the like, this system has become vastly more complicated with even the sharpest financial analyst or economics expert admitting that we have a system that we do not fully understand. Our faith in our financial system relies upon the fact that we expect others to value those pieces of paper as much as we value them. If Chuck-E-Cheese ‘s stopped accepting tickets in exchange for prizes the system would collapse. Conversely, if the child stopped working (playing the games) for paper promises and instead demanded the actual item of value the system would collapse. Faith in our financial markets and system is the basis for the work we do, the retirement we plan for, the security we strive for, and yet few people who balk at faith in religion give more than a passing thought to placing enormous faith in a volatile and finite financial system. Money is not the only place this is apparent; rather, as Steve Jobs asserts, these systems and constructs of human invention surround us.

The problem then is not with faith itself, but in the reliability of the object in which we put our faith. Our financial systems may very well be a good object in which to put our faith for handling wealth. The test for faith is whether or not the system, the object, is reliable and effective. I have faith in money because the paper from my wallet seems to be accepted in exchange for the items I would like on a regular basis. If I ever doubt this, a short jaunt to the store will reprove this point to me. Faith in religion must be handled in a similar way. Given that a plethora of options for faith exist in the world, we must continually seek and redefine our faith in our religion based upon the functionality and reliability of the object of our faith.If our faith repeatedly and reliably causes us to love God and love others more genuinely, more sacrificially, and more generously then this is a faith worth returning to. If our faith repeatedly and reliably finds us peace in a tumultuous world, hope in a hopeless struggle, and love in an otherwise dark world, this faith is worth returning to.

In any undertaking, determining the goal is essential; or, in the words of Steven Covey, “begin with the end in mind.” As I look ahead to my hopes for my future, one of the most important is to have both a successful career as a physician scientist and a spend quality time with my family and friends. In observing those around me who have attained both of these- a balancing act to say the least- I have noticed one repeating theme. Most, if not all of those who have a successful career and time with their family front loaded their career. This is to say that the elegant work-life balance they maintain now, did not extend back to the beginning of their career. Instead, most have a phase when long hours were spent devoted to their craft, their training. Whether as a single person or a young couple, the early years of those with work-life balance now is characterized by a high investment into their vocation. Long work hours early in one’s career can then be seen as a form of investment enabling investment into family later.

Tradeoffs: Early in one’s life time spend in the hospital, lab, and workplace is largely subtracted from time being entertained by a series of hobbies. However later, this time detracts from being a spouse, parent, and responsible adult.

The danger to long hours early in one’s career seems to be that this becomes a habit, a necessity. Instead of an investment into career and family later, it becomes an addiction, a way of life in and of itself. In medicine, as in every other field, one does not need to look far for an abundance of examples of those who sold out to career at the exclusion of everything else. It would seem that only by holding to the end goal of a balance of career and family can one transition from the early career aspirations to a healthy, sustainable life.

The true tradeoff then seems to be entertainment and hobby time in one’s young years for critical family time in the later years. This is not to say that some semblance of work-life balance should not be sought in the younger years of career and personal development, but that ultimately a few years of feeling unbalanced may pay dividends not only in money and promotions (penultimate goals), but in relationships and a strong family later (ultimate goals).

Note: As life is a journey of constant reassessment, one should be evaluating both short term and long term goals. I hope this post is helpful in maintaining a view of the long term while slogging through the short term; however all paths are different, and each goal individualized. So live as you are called and love everywhere you are able.

One of the defining characteristics of being human is striving. The angst driving us to do more, to be better. The pursuit of greater; the desire for progress. Sitting at a retreat for 60 MD/PhD candidates I can think of few other groups of people so defined by striving. Although striving itself is by no means unhealthy or wrong, it is a path fraught with unhealthy detours and distractions. Striving pushes us to greatness, to persevere when it would be easier to give up, to act when we would rather be still. However our striving can easily become a pursuit of fame, a need to look good in front of other, a desire to be ‘special’ and significant. As soon as this striving becomes derailed the elegance and beauty of the task in front of us is lost and all that remains is our exhaustion, frustration, and despair. No matter how well we strive or how hard we pursue, the end of such derailed striving is joyless stress and oppressive expectations.

Instead, whatever you strive for in life…

Do it because it brings you joy.

Do it because it brings you peace.

Do it because it benefits others .

Do it because you love the process, the journey, and the hope of what is to come.